OP see 2nd pg orig sketch. Expansion from 3 to 4 bedrooms onlyHTE#Ql-Harnett County Department of Public Health
E'E` s CIO
PERMIT Operation Permit 2 2 4 2 8
xpansion
❑ New Installation ❑ Septic Tank X Nitrification Line ❑ Repair 31N,
PROPERTY LO(ATION: C~vnua+ 6
Name: (owner) Q 6~, ~or~sotJ l v j g- SUBDIVISION C jmC---.ss P4\ ~ ~ ~ LOT #
System Installer: -'ca5c,,4 V'~ w-5, Registration #
Basement with plumbing: ❑ Garage ` Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well ~ C>Q feet
System Type: =K1 Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
SSE 4'' O03 U--c esi 'P es ti~ ~c,ar ~ct,~a ~N C . \ 5 ` A J C~ v z'
&44" ti.f
D-Box ❑ Pump ❑ Alarm ❑ 1-1201-ine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional ❑ Other ~-Z- V1-QW Septic Tank:
Subsurface No. of exact length width of
Drainage Field ditches of each ditch feet ditches _
French Drain Required: I_ - Livt_ e <;ZQSAL- s\-vE
\00 gallons Pump Tank: gallons
depth of
feet ditches $l 11" inches
Authorized State Agent `~l`~'`~, ~~~1`~►~,~~\R Date
HTE# Ears- Harne« County Department of Public health
PERMIT # Q-0YV Operation Permit 2 2 4 0 3
Q -e Sr"° New Installation tS~Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: CC-/9Q_-55 C~>vace~~
Name: (owner) N SUBDIVISION ' jP2&:rs-z~, P~~~SC LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage `K Number of Bedrooms
Type of Water Supply: ❑ Community 'X Public ❑ Well Distance from well 1® d feet
System Type: _AaY7 Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
Mis system has been installed in compliance with applicable north t.armma uenerai statutes, naves for Sewage treatment and uisposai, and all conditions of the improvement Permit and Construction Authorization.
1
VAl Q1 C'9_GG, f®- 0~
PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
ll. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional opera ton c(
IV. Operation:
V. Other:
maintenance and reporting.
❑ D-Box
11
Following are the specifications for the
Type of system: El Conventional
Subsurface No. of
Drainage Field ditches
French Drain Reauired: \
Pump ❑ Alarm ❑ H20Line ❑ PWR Line
sewage dispo I system on the above captioned property.
X Other ~ c P \ a V -ow Septic Tank: gallons Pump Tank: 1600 gallons
exact length width of depth of
of each ditch ~ d feet ditches 3 feet ditches inches
~r feet
Authorized State Agent '2~ 5 Date V-)-